Program Entry Survey Survey Alias * Please pick a fake name for yourself. We want to know how the group feels over time, but in an anonymous way. You can use something like your mom's middle name, a pet's name, or a number. Just make sure you will remember it. How would you describe your most recent year of motherhood, or your pregnancy if you are pregnant with your first? You can pick 3 adjectives or elaborate further, but please choose at least 3 descriptive words. If you have multiple children, feel free to explain differences between the first years of each. How would you describe your current level of social support and connection? * How would you describe the support you get from your primary relationship (spouse)? What specific challenges or concerns are you facing that you hope the peer support program can address? How do you envision the peer support program benefiting you in your personal life? Have you previously participated in any other support groups or programs? If so, what were the outcomes? Are there any specific topics or issues you would like the program to focus on? What other types of non-family, non-friend support have you sought out if any? (Ex: Individual or group therapy, coaching, support through social media platforms, in-person groups) What needs did you want those to address? Were your expectations met? Were your expectations met? I am * Pregnant with my first Pregnant and a mother of child(ren) under 5 Not pregnant, mother of one child under 5 Not pregnant, mother of more than one child under 5 Thank you! Subscribe to Our Newsletter Sign up with your email address to receive news and updates. Email Address Sign Up Thank you!
